Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Division of Vascular Surgery, Stanford University, Stanford, CA, USA.
Cardiovasc Intervent Radiol. 2020 Dec;43(12):1770-1778. doi: 10.1007/s00270-020-02526-1. Epub 2020 May 24.
Thoracic endovascular aortic repair (TEVAR) was proved to be effective in thoracic descending aortic aneurysm (TDAA) repair in 1994 and approved by the FDA in 2005. Since then, TEVAR has become the first-line, recommended treatment for intact or ruptured DTAA or as a bridge to definitive open surgical repair in connective tissue disease. TEVAR has decreased perioperative morbidity and mortality compared to open surgery due to the lack of thoracotomy, aortic cross-clamping and left heart bypass. Improvement in materials, manufacturing and device delivery systems have allowed for the expansion of indications. Thoughtful and accurate pre-procedure planning is the hallmark of successful TEVAR. Familiarization and adherence to the instructions for use for an aortic device will give the best possible chance of success.
胸主动脉腔内修复术(TEVAR)于 1994 年被证实对胸降主动脉瘤(TDAA)的修复有效,并于 2005 年获得 FDA 批准。从那时起,TEVAR 已成为结缔组织疾病患者未破裂或破裂的 DTAA 的一线、推荐治疗方法,或作为通向确定性开放手术修复的桥梁。由于避免了开胸、主动脉阻断和左心旁路,TEVAR 降低了围手术期发病率和死亡率。材料、制造和器械输送系统的改进使适应证得以扩大。术前周密、准确的计划是 TEVAR 成功的关键。熟悉并遵守主动脉器械的使用说明将最大限度地提高成功的机会。